Corresponding Member Prof. Georgi Momekov: The Pharmacists of the Future - How the Biological Era is Transforming Science, Safety, and Academic Training

As of May 1, 2025, Corresponding Member Prof. Georgi Momekov, DSc, assumes the position of Dean of the Faculty of Pharmacy (FP) for the 2025–2029 term, following his election by the General Assembly of the faculty. A prominent scientist and educator with over two decades of academic experience, Prof. Momekov has developed his entire professional career at the FP of the Medical University – Sofia, progressing through all academic ranks and defending both a PhD and a Doctor of Science degree. An established academic leader and corresponding member of the Bulgarian Academy of Sciences, he is a national authority in oncopharmacology. In 2025, Prof. Momekov was honored with the prestigious “Golden Panacea” award, a recognition of his outstanding contribution to the development of pharmaceutical science and the academic community. He leads key expert structures, including the National Expert Council on Clinical Pharmacy, and is a member of the National Expert Council on Immunizations at the Ministry of Health. As Chairman of the Bulgarian Scientific Society of Pharmacy and a long-standing academic lecturer, Prof. Momekov plays a leading role in modernizing pharmaceutical education and research in Bulgaria.

Pharmacy, or the complex mix of the science and practice of medicinal knowledge, has always been a territory where scientific creativity eventually becomes reality. However, the changes we observe today are unprecedented in scale and speed. Within a single generation, we have moved from the relatively clear world of small molecules to a dominant landscape of biological and genetically based therapies that do not merely treat symptoms but rewrite cellular functions and sometimes even their very future.

Until recently, experts in medicinal science relied on the intuition instilled by years of training in physiology, biochemistry, pharmacology, organic, and pharmaceutical chemistry—small molecules possess properties that allow for the prediction of many characteristics, mechanisms, and behaviors. Today, however, a large portion of emerging drugs are peptides and proteins, including analogs of endogenous hormones and cytokines, monoclonal antibodies, fusion proteins, peptidomimetics, and other macromolecules such as aptamers, small interfering RNAs, and antisense oligonucleotides. This also includes cutting-edge therapeutic modalities like gene therapies using viral vectors, cell therapies such as CAR-T cells, and even genome editing via CRISPR-based systems. These are not just new tools in the medical and pharmaceutical arsenal; they represent a fundamentally different way of influencing biology and pathological processes. Instead of modifying enzymes or receptors, these therapies can reprogram cells, activate immune cascades, replace defective genes, or seek out pathological cells with the precision of biological “projectiles.”

These trends toward the global implementation of such advanced therapeutic systems necessitate a significant emphasis on molecular biology, immunology, modern biotechnology, and specific approaches for developing appropriate drug carriers, often within the realm of nanotechnology. This undoubtedly leads to the need for a substantial modification of curricula, which have primarily focused on the pharmaceutical aspects of small molecules—the majority of conventional drugs known to us until the end of the last century.

It is precisely this transformation that is changing the profession of the pharmacist much more deeply than we usually realize. It begins in the lecture hall. Today’s students enter university with broader access to information than any previous generation—over-informed, technologically oriented, critical of authority, and sensitive to the practical value of knowledge. For them, the classical style of teaching is too restrictive. They expect interactivity, arguments, real-world clinical examples, and situations where they can apply what they have learned.

The lecture is no longer a monologue; it is a conversation where science, ethics, reality, and imagination meet.

Education must change to meet the needs of this generation. It must create thinking individuals, not just information carriers. With biological therapies, knowledge cannot be acquired through rote memorization; a systemic understanding is required. What does “immunogenicity” mean? What is the difference between an antibody that blocks a receptor and one that recruits immune cells via its Fc fragment? Why can gene therapy be a one-time treatment with a lifelong effect? What is an “off-target” mutation in CRISPR editing? All these questions lead students not only deeper into science but deeper into the logic that builds that science.

If the university fails to keep pace, it risks becoming a museum of ideas that have already fallen behind practice. Because in the world of biological therapies, changes do not happen over decades, but over months.

The speed of development is also a challenge for regulatory science. Classical toxicology, built on the logic of small molecules, is no longer sufficient. With antibodies, the danger is not chemical toxicity but excessive immune activity; with gene therapies, it is the unpredictable integration of the vector into the genome; with cell therapies, it is uncontrolled proliferation or cytokine storms. This requires new methods of preclinical assessment, including complex in vitro models, bioinformatics, transgenic animal models, highly sensitive biomarkers, and machine learning predictions.

Even clinical trials are changing. There is a shift from studying large patient groups to extremely targeted populations, often with rare diseases. Classical Phases I, II, and III are increasingly replaced by adaptive or hybrid designs that collect data not so much for standard pharmacokinetic curves, but for immune response dynamics, molecular biomarkers, or functional correlates. Furthermore, after approval, so-called post-marketing surveillance becomes a key stage in a drug’s life cycle, involving registries, biological monitoring, and real-world clinical practice tracking that often spans decades.

This is where artificial intelligence emerges—not as a replacement for the specialist, but as a powerful tool. AI is already involved in analyzing clinical trial data, identifying rare safety signals, modeling drug interactions, predicting immunogenicity, and optimizing dosages for personalized therapies. However, the task of the future pharmacist is to distinguish the useful from the misleading, to interpret results with critical thinking, and to place scientific ethics above the “easy solutions” offered by algorithms.

Against this backdrop, the role of the pharmacist is rising to an unprecedented level. They are no longer just drug specialists but are becoming integrators of knowledge, intermediaries between innovation and the patient, guardians of safety, and vital members of the multidisciplinary teams shaping the therapies of the future. To be a pharmacist means to understand science but also to be able to translate it; to think critically but also to act ethically; to learn continuously, because any delay sets you back years in a field moving at incredible speed.

Therefore, the greatest challenge for education is not to cover the curriculum, but to inspire students to feel part of a scientific mission. To teach them to ask difficult questions, to question the obvious, and to accept uncertainty as a driver of knowledge rather than an obstacle. In the scientific world, dogma is the enemy, and doubt is a tool for development; in other words, science is a culture of debate.

The era of biological therapies is changing the very face of pharmacy. But this is not a threat; it is an opportunity. An opportunity for students to become the generation that does not just memorize, but understands. The generation that will not just follow, but lead. The generation of pharmacists who will turn science from a set of facts into a tool for human salvation. Because no matter how complex technology becomes, the most important element will always remain the same: the thinking person, armed with knowledge, responsibility, and the courage to change the future.

Instead of an epilogue: For centuries, Europeans believed that the world ended at the Pillars of Hercules—the rock formations on either side of the strait at present-day Gibraltar. They were not just a geographical boundary but a symbolic line: beyond them lay the “unknown,” the “impossible,” the “impermissible.” Thus, the old inscription placed on maps warned: Non plus ultra – “No further.”

At the beginning of the 16th century, Charles V, King of Spain and Holy Roman Emperor, reversed this view. As the ruler of one of the largest empires in history, he promoted the idea that true progress begins precisely when we step across the boundary of the known. Thus, his motto became Plus ultra – “Further beyond.” A call for courage, the expansion of horizons, and trust in science, knowledge, and human potential.

This spirit is unexpectedly resonant with the mission of the pharmacists of the future. Today, the profession is moving beyond its traditional role and entering new territories—personalized therapies, pharmacogenomics, digital care models, data analysis, and clinical partnerships. The pharmacist of the future is transforming from traditional roles into a navigator of complex situations and solutions, a mediator between the patient and technology, and a guardian of quality and safety.